Welcome to TwoGreenDocs!

We're two recent medical school grads who are passionate about medical education, healthcare policy, and pretty much everything related to human health. Our blog is a mix of all these topics, with a little travel and food thrown in for good measure. We hope that you'll find something here that you're passionate about, and maybe even learn something while you're at it!

Native Ads

How to create a USMLE Step 1 Study Schedule

Every medical student dreads the USMLE Step 1, and for good reason. Step 1 scores are commonly cited by residency programs as one of the most important (if not THE most important) factors that they consider when ranking applicants. Doing well on this exam can mean the difference between matching into the program of your dreams and having to scramble into a program hours away from friends and family in a specialty you hate. That’s why it’s important to have a USMLE Step 1 Study Schedule to keep you focused and on track to perform your best.

The difference between a good and a poor student is the result.

- ETC Wanyanwu

After the end of the second year of medical school, most programs leave a 4-6 week gap in the schedule before you start clinical rotations. The gap is commonly referred to as your “dedicated” time, which is typically… you guessed it… dedicated to focused study for Step 1. This month and half is filled with long days spent in the library or cramped in study rooms. Many medical students burn out during during the focused study period, and can even develop depression due to the isolation and stress involved. The best way to combat the study fatigue and stress is to enter with a plan.

Why you should have a USMLE Step 1 Study Schedule:

I’m a big believer in breaking up your goals into achievable pieces. To-Do lists, schedules, task lists, whatever. When I was a collegiate athlete, I would never have been able to be consistent in my training without a pre-defined workout schedule. Our coach would put together personalized weekly, monthly, and quarterly training schedules for each member of our team. Each schedule was tailored to focus on each individual’s weaknesses. My personal training plan was a key element in my success, and I have continued to use similar methods throughout my training.

The most common complaints I hear from students during their dedicated period involve study anxiety. Manifestations of study anxiety vary widely, but are usually associated with fixation on question bank performance or loss of focus. Many students do poorly on a block of questions and are then paralyzed by their fears of poor performance. All studying stops, sometimes for an entire day! Other students burn out after three to four weeks and find themselves unable to focus on the material. Half hour lectures take two hours to complete. Untimed blocks of questions drag on for hours… It’ll happen to almost every student at some point during their dedicated study.

The value of a USMLE Step 1 study schedule lies in keeping you out of study paralysis. You always know what you need to accomplish every day. Even when you bomb a UWORLD block (and it’s a when, not an if), you know that you need to finish a certain number of flashcards or Pathoma lectures before you are done.

Things to know before making your Step 1 Study Schedule:

Before you make a USMLE Step 1 study schedule, you need to have a few details nailed down. Most importantly, you need to have a test date. I know, it’s very hard to plan 5-6 months out and pick a date for the most important exam of your life. There will always be drawbacks, and there is no magical day that is better than any other. You need to just bite the bullet and pick a date.

After picking a date, you need to decide which resources you’re going to use. There’s are way too many resources out there to go over here, but we have already gone over some of the most popular ones on our first year medical school guide. [link] I am going to assume that you will be at least using UWORLD, FistAid for the USMLE, and Pathoma. For more information about different resources, check out our First Year Medical School Guide.

Finally, you need to decide on how many NBME practice tests you are planning on taking. We recommend taking at least 3 over the course of your study. Typically, the more recent exams (NBME 15 and 17 etc) are considered the most accurate examples of what your exam will feel like. If you are an Osteopathic student, you will likely want to take a practice NOBME test or two as well.

Once you have your date set, resources chosen, and know how many practice tests you want to do, it’s time to make your USMLE Step 1 study schedule.

How to make your Step 1 study schedule:

I used Microsoft Excel to make my schedule, but you can use Google Sheets or do whatever you want. You could even put individual post-it notes on a calendar if it makes you feel better to take them down. For all of the planning I am assuming you are taking 6 weeks of dedicated study.

1. Figure out how many days you have until the exam.

We recommend a minimum of 4 weeks of hardcore study. If your school schedule allows for it, I personally found 6 weeks to be the upper limit of what I could tolerate. After five weeks of 8-12 hours of daily review, you start to plateau. You want enough to time to just reach your plateau without backsliding. Count the number of days you will have to study and number the rows in your spreadsheet accordingly.

2. Block off special days:

Completely block off the day before your exam. Even if you end up wanting to study a little, you should only be reviewing a few notes or lightly going over UWORLD explanations. By this time you should have finished and reviewed ALL UWORLD questions, and be done with your other resources. You will want this day to zone out or go outside.

I’d also recommend blocking off one other full day off 5-7 days prior to your exam. You will be reaching your burn-out threshold and will need a mental health day. Again, even if you don’t use this off day, you will be glad for the catch up time.

3. Assign your practice tests to specific days

If you are taking 3 practice tests, we recommend taking one after your first week of review to get a baseline. Take your second after week 4, and take your last test 3-5 days before the real exam. Don’t plan anything else on those days, as it will take 6-7 hours at a minimum to take the exam and review the wrong answers. It doesn’t really matter what tests you take, but we recommend taking the most recent one (NBME 17 when I was a wee second year) just before the real deal.

4. Decide on how many hours a day you plan to study

The knee-jerk reaction when making a study schedule is to plan on 8+ hours a day, everyday. On paper, 6AM-6PM with a little passive review from 9-10PM before bed sounds reasonable when preparing for the most important exam of your career. I mean, theoretically this results in the most study time right?

Overscheduling yourself is an easy way to create even more stress when you inevitably fall behind. The biggest strength of my USMLE Step 1 Study Schedule was not planning on more work than I could handle.

We highly recommend not planning on studying for more than 6-8 hours a day, broken up into two 3-4 hour blocks. That way, if you get through the material and have energy/motivation left over, then great! You can keep studying. However, you will find that by week 2 or 3 motivation will be in short supply, and what you think will take 6 hours may take 9.

Additionally, I recommend planning one light day every week (~4 study hours, a.k.a two UWORLD blocks with review). I usually used my light day to catch up if I fell behind that week, and to do any errands that needed to be done. In my sample schedule you will also see a few days dedicated solely to catching up. Every single one was used for that purpose.

5. Divide up your resources.

Figuring out exactly what you are going to do every day is the most tedious part of making a Step 1 study schedule. I figured out which resources I felt were the most useful to me and then split them up based on priority. For example, I felt (and still feel) that the UWORLD question bank is the #1 best thing you can do to prepare for Step 1. Each blocks of 42 questions was assigned to a specific day on my schedule, numbered 1-59(ish). Most days I planned on doing at least one block, with a maximum of two blocks per day.

I then did the same thing for Pathoma videos, and continued to move down my priority list until I ran out of time. The key here is to not overplan. Make every day’s goals achievable, even if it means having extra time at the end of the day. Remember to go easy on your light days.

6. Make your USMLE Step 1 Study Schedule look good.

I color coded my list by week, and highlighted my important days (such as practice tests and the actual step 1. If you’re gonna print out and keep something, might as well make it pleasant to look at. Just kidding, looking at that piece of paper will never be anything other than stressful.

Sample Schedule:

All right, time for the example. As promised, I have included a picture of my USMLE Step 1 study schedule with a link to a google-drive version that you can access. You will not be able to edit the document on the drive, so copy and paste it into your own spreadsheet.